When back pain interrupts sleep, work or walking, it is understandable to look for something that might help. Searching online can leave you with conflicting messages: personal success stories, treatment advertisements and clinical recommendations that appear to disagree.
As a Registered Nurse and Medical Acupuncturist, I believe you should be able to understand those recommendations before deciding whether to enquire about treatment. The important starting point is this: NICE advises against offering acupuncture for low back pain with or without sciatica. That should be stated plainly, including on an acupuncture clinic’s website. NICE NG59, recommendation 1.2.8
Back pain and sciatica describe different experiences
Sciatica involves irritation or compression of the sciatic nerve. Symptoms commonly affect the bottom and back of one leg and may extend to the foot or toes. Pain can occur with tingling, numbness or weakness. Back pain alone is not usually sciatica. NHS guidance on sciatica
An online description cannot establish what is causing your symptoms. When you speak to a clinician, explain where the pain travels, whether you have noticed weakness or altered sensation and what has changed over time. If you already have a diagnosis, bring that information rather than assuming that another treatment should replace your existing care.
Why you may have heard that NICE recommends acupuncture
NICE has a different guideline for chronic primary pain. It allows consideration of one course of acupuncture or dry needling for people aged 16 and over, subject to practitioner-training, setting and time or equivalent-cost conditions. NICE NG193, recommendation 1.2.5
That is a different clinical situation. It does not cancel the low-back-pain recommendation. Nor does having pain for a long time automatically make acupuncture a recommended treatment for your back pain or sciatica.
My responsibility is to help you make sense of the guidance, rather than selecting the recommendation that makes a treatment sound most appealing. You should be able to ask how any proposed treatment relates to your particular problem.
What the low back pain guidance does recommend
NICE emphasises advice tailored to the person, support for continuing normal activities and consideration of suitable exercise programmes. Manual therapy is considered only within a package that includes exercise, with or without psychological therapy. Routine scans are not recommended in non-specialist settings; specialist imaging is considered when it is likely to change management. NICE NG59 recommendations on assessment and non-invasive treatment
A useful conversation with your GP or physiotherapist is therefore about a plan: what you can safely do, what support is available and what would mean the plan needs reviewing. You should not have to work that out from a list of treatments on a search-results page.
Symptoms that need emergency care
The NHS advises going to A&E or calling 999 for sciatica on both sides, severe or worsening weakness or numbness in both legs, numbness around the genitals or anus, or new difficulty starting, controlling or passing urine. New loss of awareness or control of bowel movements also needs emergency assessment. Do not wait for a clinic appointment with these symptoms. NHS sciatica emergency advice
What an enquiry with me can clarify
An enquiry is a chance to explain what you are looking for and ask about suitability. It is not a promise that acupuncture is appropriate or will relieve your symptoms. I want to know about your diagnoses, medicines, investigations and any GP or physiotherapy care so that we can discuss your situation properly.
You can read our back-pain information and meet me before getting in touch. MAW Clinic is inside Thomas Medical Services in Thornton-Cleveleys, near Blackpool.
For non-urgent questions or to enquire about bookings, please contact me. If your symptoms need medical assessment first, that takes priority.